Voluntary benefits are becoming increasingly important to employees as they focus on their physical, mental, social and financial health. As a result, many employers have expanded their voluntary benefits offerings to address employees’ needs and improve their attraction and retention efforts.

Among these offerings are disability benefits, which can provide guaranteed income or job protection to employees who are unable to work due to serious illness or injury. The most common disability benefits are short-term disability (STD) and long-term disability (LTD) insurance. However, understanding the differences between STD and LTD benefits and other laws, such as the Consolidated Omnibus Reconciliation Act (COBRA), can be complicated and difficult for employers to navigate.

What Are STD and LTD?

STD and LTD insurance are the most common forms of disability benefits.

 Short-term Disability Insurance

STD insurance replaces all or a portion of an employee’s income due to a temporary disability. Under STD plans, employees receive a percentage of their income, typically 40% to 70% of their base pay, but employers can allow employees to supplement their STD benefits with paid sick leave or other benefits. An STD insurance policy is paid either fully or partially by the employer, and the median length of STD insurance coverage is 26 weeks, according to the U.S. Bureau of Labor Statistics.

To qualify for STD insurance, an employee files a claim under their insurance policy. The employee must prove their illness or injury qualifies as a disability under the plan’s terms. STD insurance generally requires employees to wait for a short period—on average, seven days—before they start receiving benefits to discourage abuse and because many employers’ paid-time-off benefits cover shorter absences than those covered by STD insurance. While STD insurance plans do not guarantee job protection, employees may be entitled to it through their employers’ policies or under state and federal laws, such as the Family and Medical Leave Act.

Employers offer STD insurance because it helps employees remain financially stable while recovering from an illness or injury, allowing them to stay productive and focused when they’re physically able to return to work. Since the income employees receive under STD insurance is paid by insurance companies, employers have the financial resources and flexibility to hire temporary or contract workers to fill workforce gaps without experiencing high labor costs. In states that don’t require employers to participate in disability income plans, employers can offer full, partial or noncontributor STD insurance plans.

Long-term Disability Insurance

LTD insurance provides employees with income for long-term illnesses and injuries. Employees generally receive 60% to 80%of their base pay; however, some employers’ LTD plans offer more limited income replacement benefits. Similar to STD, employees receive income benefits until they are able to return to work or have exhausted policy limits. LTD benefits requirements tend to be more rigorous than STD because workers need to demonstrate they’re unable to perform any job, not just the job they were working before the illness or injury.

These plans often work together with STD, so when an employee exhausts their STD benefits, LTD benefits continue to provide the employee with income. As with STD benefits, LTD does not provide workers with job protection. Employees who become permanently disabled may continue to receive LTD benefits through their retirement date or until they’re eligible for Social Security disability benefits.

What Is COBRA?

COBRA allows individuals to continue their group health plan coverage in certain situations. This law requires group health plans maintained by private-sector employers with at least 20 employees to offer continuation coverage to covered employees and dependents when coverage would otherwise be lost due to certain specific events. These events include the following:

  • Death
  • Termination
  • Reduction in employment hours below the plan’s eligibility requirements
  • Divorce or legal separation
  • Medicare eligible
  • Child’s loss of dependent status under the plan’s rules

COBRA sets rules for how and when continuation coverage must be offered, how employees and their families may elect continuation coverage, and when continuation coverage may be terminated. Employers may require individuals to pay for COBRA coverage. Group health coverage for COBRA participants is usually more expensive than coverage for active employees because many employers pay a portion of the premium for active employees.

COBRA continuation applies to plans that qualify as group health plans as defined by the Employee Retirement Income Security Act (ERISA). Under ERISA, a group health plan must be a plan, fund, or program that is established or maintained by an employer and has the purpose of providing medical care. Health insurance plans, self-funded health plans, health maintenance organizations and prescription drug plans generally meet ERISA’s criteria for a group health plan. Medical care is defined as care for the diagnosis, cure, mitigation, treatment or prevention of disease and any other undertaking affecting any structure or function of the body.

The Differences Between STD and LTD and COBRA

An employer is not required to offer COBRA continuation on a voluntary benefits plan if the plan does not qualify as a group health plan and the plan is considered completely voluntary. STD and LTD benefits generally provide income replacement for individuals who must take a leave of absence from work due to a qualifying condition instead of medical care. Because STD and LTD typically do not provide medical care, they’re not subject to COBRA and would not be required to continue under COBRA. However, although uncommon, if an STD or LTD insurance provided medical care, it may be considered a group health plan under COBRA and subject to continuation coverage.

While STD and LTD benefits are generally not subject to continuation coverage under COBRA, an employee’s disability can initiate COBRA requirements if it produces a qualifying event. For example, if an employee becomes disabled and doesn’t return to work at the end of their disability leave or notifies their employer of their intent not to return, the employer’s plan will determine whether this is a qualifying event. If this is determined a qualifying event, COBRA requires the employer to notify the employee of their COBRA rights and provide the employee with the option to continue group health insurance coverage.

Summary

STD and LTD benefits can provide sick and injured employees with financial stability and peace of mind when they’re unable to work. Understanding how these types of disability insurance differ from COBRA can help employers stay compliant and ensure employees have the benefits they need and desire.

This document is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel or an insurance professional for appropriate advice. © 2023 Zywave, Inc. All rights reserved.

LOCATIONS

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Glastonbury, CT 06033
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Guilford, CT 06437
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377 Main Street
Unit 103
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860-652-3235
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Plainfield, CT 06374
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Windsor Locks, CT 06096
860-652-3235

 

229 Main Street
Milford, MA 01757
508-473-4045
182 Main Street, Suite 202
Northampton, MA 01060
844-923-7873
300 Main Street
Oxford, MA 01540
508-987-0333
195 Lake Ave,
Worcester, MA 01604
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70 Tanner Street
Haddonfield, NJ 08033
800-220-3434

 

6 McMaster Street, Suite 2
Owego, NY 13827
607-687-3444
14 Columbia Circle, Suite 204
Albany, NY 12203
518-477-5150
300 Plaza Drive
Vestal, NY 13850
607-754-1411
418 Waverly Street
Waverly, NY 14892
607-565-2872

 

68 National Drive
Glastonbury, CT 06033
860-652-3235
1110 Boston Post Rd
Guilford, CT 06437
203-458-4000
501 Main St, Monroe, CT 06468
Surety | Suite 2D | 203-445-8388
Business & Personal Insurance | Suite 101 | 203-268-9999
377 Main Street
Unit 103
Niantic, CT 06357
860-652-3235
127 Norwich Rd
Plainfield, CT 06374
860-564-3315
363 So Center Street
Windsor Locks, CT 06096
860-652-3235
229 Main Street
Milford, MA 01757
508-473-4045
182 Main Street, Suite 202
Northampton, MA 01060
844-923-7873
300 Main Street
Oxford, MA 01540
508-987-0333
195 Lake Ave,
Worcester, MA 01604
508-969-1786
70 Tanner Street
Haddonfield, NJ 08033
800-220-3434

 

6 McMaster Street, Suite 2
Owego, NY 13827
607-687-3444
14 Columbia Circle, Suite 204
Albany, NY 12203
518-477-5150
300 Plaza Drive
Vestal, NY 13850
607-754-1411
418 Waverly Street
Waverly, NY 14892
607-565-2872